The approaches described in this section could be pursued, but are not necessarily approaches that have been previously conceived or pursued. Therefore, unless otherwise indicated herein, the approaches described in this section are not prior art to the claims in this application and are not admitted to be prior art by inclusion in this section.
Vascular disease occurs widely in humans and is a significant cause of premature death in many human populations. In general, vascular disease is characterized by the accumulation of fatty deposits on the walls of the arteries, causing the arterial walls to thicken and become less elastic. As a result, the flow of blood to all cells and tissues of the body is reduced. Heart disease is an example of vascular disease. Coronary artery disease is the leading cause of death in the adult population of the United States.
The medical community recognizes that the incidence of vascular disease in many populations can be reduced significantly. One way to reduce the incidence of vascular disease is to improve identification of individuals' risks for hypertension, elevated cholesterol, obesity, diabetes, smoking, inactivity and aging. Vascular disease is strongly associated with these conditions. As one commentator has observed, “[t]ools that would quantify all cardiovascular risks for use with hypertension would be a welcome and even more powerful aid than the additive technique we now have.” See S. Sheps, “Treating Hypertension,” Hippocrates, v. 13 no. 11 (Dec. 1999).
Presently, medical evaluation and treatment of vascular disease involves using vascular studies to determine whether an individual presenting symptoms are due to vascular disease. Such studies may involve use of procedures and machines such as magnetic resonance imaging, angiograms, thallium scans, and others, many of which are expensive to administer. As a result, they are generally used only in patients who already exhibit other symptoms of vascular disease, or who have other associated health problems. Recently the American Heart Association issued a Scientific Statement (see Circulation, 2000;101:e3 and Circulation, 2000;101 el 63) suggesting possible evaluation interventions using ankle brachial blood pressure, ultrasound and volume studies and scans. However, these methods are not widely used at the clinical level for evaluation of vascular disease.
Currently, Doppler vascular studies are performed to evaluate peripheral artery disease occurring in the arms or legs. Further, the AHA Scientific Statement identified above references prior work in using duplex vascular studies of the carotid arteries to determine and correlate anatomical changes of the coronary arteries. However, Doppler vascular studies (functional studies) of the peripheral circulatory system are not presently used to evaluate risk of cardiovascular disease, and are not used to evaluate risk in asymptomatic individuals.
Even when vascular disease is successfully identified in a patient, the current standard of care has drawbacks. For example, drugs of the class known as beta blockers are commonly prescribed, but these often cause significant complications, including depression of the heart, emotional depression, impotence, effects on diabetic control, effects on exercise, etc.
Biofeedback techniques are known for treating certain kinds of health problems by training people to respond to signals from their own bodies. See, e.g., B. Runck, “What is Biofeedback?,” National Institute of Mental Health, Dept. of Health & Human Services Pub. No. (ADM) 83–1273. However, biofeedback is not presently applied to the treatment of vascular disease.
Still another problem associated with treatment of vascular disease is that health care providers lack the ability to receive and evaluate data about the then-current vascular health of an individual outside the clinical setting. Certain techniques for obtaining snapshots of data are known. For example, a Holter monitor may be used to gather an electrocardiogram from an individual during that person's normal activities away from a clinical setting. Conventional EKG electrodes are attached to the individual at a clinic, and the electrodes are coupled to a portable data collection device that measures and stores EKG data over a specified period of time, typically 24 hours. After the data collection period, the individual returns to the clinic, where the data is downloaded into a computer for analysis, and the monitor is removed. However, Holter monitors are not reliable, and may indicate cardiac disease only when it is severe. The same disadvantages are known with respect to treadmill stress tests.
Past approaches to addressing similar problems include certain online businesses. For example, “Healtheheart.com” offers online monitoring of cardiovascular diseases and online storage of clinical records, but is offered only to physicians and essentially monitors only disease conditions. “Stayhealthy.com” provides certain online tools for health evaluation, but functions only as an information service. “Wellmed.com” offers online services for personal health including personalized records and clinic files. “Lifemasters.com” provides online monitoring of patients with chronic diseases. “Dynapulse.com” provides blood pressure monitoring devices to measure cardiac function based on blood pressure readings that are uploaded over the Internet. An analysis center interprets data and provides reports. None of these approaches, however, uses biofeedback interactions, and none uses Doppler vascular data obtained from the peripheral vascular system as a global measurement tool for evaluating vascular disease.
Based on the foregoing, there is a need for a way for improved systems and methods for treatment of vascular disease.
There is also a need for a way for a healthcare provider to collect vascular data from an individual who is engaging in normal daily activities, away from a clinic, over a long period of time, such as months or years.
There is also a need for a way for a patient and a healthcare provider to concurrently have access to such vascular data.
Further, it would be beneficial to have ways for patients to engage in self-directed follow-up treatment of vascular disease through biofeedback techniques, after the initial physician evaluation.